Dr Carla Hannaford - Course Registration

The Life You Want is organising Dr Carla Hannaford's courses on behalf of Brain Gym in SAIf you want more information on Dr Carla Hannaford's courses, please phone Hanna Kok 082 856 6655Please complete the form below to register for one of our upcoming courses. We will use this information to create your invoiceCourse deposits are to be made into the following FNB bank account: Brain Gym in South Africa Account No: 623 57000 646, Branch Code 250 117. Use your name and course names as the reference .

Course Registration Form

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Who would you like the invoice to be made out to? *

Select the course you would like to register for from the menu below *

Which Course Dates Would you like to attend? *

Number of attendees *

Is there anything else you would like us to know? If you attend more than one course, please list here the other courses you will attend *